Future Fit: Bankrupt in every respect

Help us tell hospital bosses to STOP their plans to close an A&E and hospital. We expect their closure plans to be discussed and agreed on Thursday 31st March at 2pm, at the Education and Conference Centre, Royal Shrewsbury Hospital. It’s a public meeting, and all of us are entitled to be there. Can you come along?

Remember the hype about ‘Future Fit’, the NHS cuts and closures plan? NHS bosses have always claimed that it was OK to close one of our A&Es and one of our hospitals, either Shrewsbury or Telford, because new services would take their place. They made some very concrete promises. They promised a ‘network of urgent care centres’. Last summer, they were still giving the impression at public workshops that there wouldn’t just be urban Urgent Care Centres at Telford and Shrewsbury. They told us that there would be rural Urgent Care Centres as well: in Oswestry, Whitchurch, Bridgnorth, Bishop’s Castle and Ludlow. These were going to give us sophisticated care 16 hours a day, 7 days a week. They were ‘closer to home’, so apparently it didn’t matter that the A&E might be much, much further away.

The promises weren’t just about the network of Urgent Care Centres. The Future Fit clinical model is about shifting 30% of activity out of hospital settings and into the community. The clinical model behind Future Fit makes it clear that this can’t work possibly without significant investment of resources. We’ve been promised a lot: preventative services, care planning, active case management offering ‘holistic and pro-active care with planned reviews and assessments’, palliative and end of life care… The consistent claim from NHS leaders has been that the funding will be there to make it work, and that care will get much better than it is now.

As recently as August 2015, Future Fit leaders pledged new investment of £5.3 million a year, each and every year, to pay for these new services. This commitment is in the minutes of the August Shropshire CCG Board meeting (page 19 of downloaded document) and was in a letter sent last summer to every GP in Shropshire.

All of the promises are now shown to be worthless. In Shropshire there is NO money for investment in new community services, and no money for Rural Urgent Care Centres. This staggering admission was made last week in a letter written by CCG Chair Helen Herritty. You can find the letter here. Dr Herritty explains that the CCG’s priority is to restore its financial position and repay the deficit. She says this means ‘it is not likely that the CCG will have additional resource to invest in community services’. Hospital cuts are still to go ahead – and the CCG will be reduced to scrabbling around, in competition with every NHS organisation in England, trying to secure a few bob from a national fund that has multiple demands on its very limited resources. The notion that this will pay for adequate community services is a sick joke.

Is the NHS in Telford and Wrekin in a stronger situation? Only marginally! Shropshire is worse off because NHS funding policy discriminates against rural areas and areas with an older population – but the catastrophic national squeeze on NHS funding leaves Telford and Wrekin in crisis as well. In the coming financial year, Telford and Wrekin’s NHS will be making cuts of £5.2 million. There is no realistic prospect of Telford and Wrekin investing substantial resources into community NHS services at the same time as it makes deep cuts in spending. The only difference between Shropshire and Telford and Wrekin is in the degree of crisis facing the NHS.

Future Fit is bankrupt. It is financially bankrupt because the money to give it any chance of working has been snatched away; it is clinically bankrupt as well. All of the modelling work to ‘prove’ that Future Fit can work has been based on the assumption that there will be a network of Urgent Care Centres, combined with heavy investment in new community services. With no investment at all, the model falls apart. Future Fit cannot work without investment in alternatives to A&E and hospital care. What we now face are cuts, plain and simple: the closure of one of our A&Es; the replacement of one of our hospitals – Telford or Shrewsbury – with a 20 bed planned care unit; and a disastrous 30% of hospital activity dumped onto GPs, community NHS services and social care. All of these services are stretched to the limit already. It is ludicrous to think that they can simply absorb 30% of the work from our hospitals, with no funding at all to do it.

Bizarrely, it still looks as though NHS bosses will sign off the Future Fit plans. If they do, they are signing a death sentence for a significant number of local people. They still won’t say which A&E and hospital they want to close. We’re clear: we need both, and we have to campaign hard for both to stay open. Whichever A&E and hospital goes, the risks of unnecessary pain, suffering and death will escalate. We just can’t let this happen.

The next key date is 31st March, when the Hospital Trust will sign off a Future Fit document called the ‘Strategic Outline Case’. This document commits them in principle to closing down one of the A&Es and one of the hospitals. Can you come to the meeting, and help make the voice of the public heard? The meeting will be at the Royal Shrewsbury Hospital, at 2.00 pm on Thursday 31st March; we expect it to be in the Education and Conference Centre on the hospital site.

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